What happened to the "Emergency" in "Emergency Room?"

Specialties Emergency

Published

Hi everyone,

I work in a large, urban ED. I absolutely love emergency medicine, and like many of you, cannot imagine myself doing anything else. However, I have recently been left feeling burnt out with all the non-emergent cases we see. Its as if treating and caring for a patient who is actually sick, critical or unstable just doesn't happen anymore. What happened to these patients? Where did they all go? We are so bogged down with low acuity patients, who also seem to be the most entitled, mean, and in-your-face. It is discouraging to say the least, but I'm not sure where to turn from here. Emergency nursing is my passion. Are any of you experiencing this as well? What are you doing about it? What happened to the "emergency" in "emergency medicine?"

Specializes in Emergency.

If the only patients who came to the er were full-on esi 1 & 2's, we'd be almost out of business.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Well if we are going to continue repeating ourselves as if that provides any extra credibility, let me then once again include " Just a standard UTI (constant urge to urinate, pain when stopping urination, blood in urine, urge incontinence)" is interpreted by an ER nurse as minor. If you come into my ER and explained your symptoms as such we would send you to fast track obtain a urine and send you home. If you came into our ER stating pain so bad you can't walk straight Ect Ect you would be evaluated in a regular room. So once again as I stated before (WHICH I CANT REPEAT ENOUGH) is that your ORIGINAL post (let me repeat ORIGINAL post), did not indicate anything to a triage nurse that she would jump up and down about. I am only able to interpret your situation from what you simply stated. Now after my response from your ORIGINAL post (let me repeat ORIGINAL post) you became defensive and started to include sepsis and pylonephritis. Please reread your original description of your UTI and calm yourself down. You are grasping at straws here.

I will gladly discuss sepsis and pylo, but, in a separate category than "standard UTI" as you stated. Thank you.

But a "standard UTI" would still warrant fast-track treatment.... THAT is my point, not that a full-on trauma response would be necessary. :wacky:

When there is no urgent care or minute clinic or PCP available for a few days, it is not beyond the realm to seek treatment for a UTI from the local ER. Letting the infection progress further is in nobody's best interest.

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Well of course we would place you somewhere if you came in the ER. We are not allowed to send you away. Duh!! We are forced to see tons of patients that shouldn't be there or use the ER as their PCP, OB, dentist office Ect. No, particular s/s do not "warrant" fast track, but, like I said the ER is "obligated" to see every individual that walks through the door, regardless of how eyerolling the "EMERGENT" s/s are. I find, as well as many nurses I work with, that true patients that need immediate attention are compassionate and understanding. But like I said if you would like to discuss sepsis and pylo we can. Maybe wait a day and see how your "standard or normal" s/s feel. You were able to finish out work correct?

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Well of course we would place you somewhere if you came in the ER. We are not allowed to send you away. Duh!! We are forced to see tons of patients that shouldn't be there or use the ER as their PCP, OB, dentist office Ect. No, particular s/s do not "warrant" fast track, but, like I said the ER is "obligated" to see every individual that walks through the door, regardless of how eyerolling the "EMERGENT" s/s are. I find, as well as many nurses I work with, that true patients that need immediate attention are compassionate and understanding. But like I said if you would like to discuss sepsis and pylo we can. Maybe wait a day and see how your "standard or normal" s/s feel. You were able to finish out work correct?

I can't believe that this is something that is even "up for debate" but here goes:

Based on previous UTI experiences I had already lived through, once blood appears in the urine, the urge incontinence ramps up quite quickly, to the point that I'm essentially living on the toilet or constantly dribbling bloody pee in my pants.

I had to work at 8:30 the following morning for a four-hour shift at my first job, plus work an afternoon/evening shift at my second job. There would be no way for me to work either of those shifts with such a huge incontinence issue. I was also scheduled to work at the second job on Sunday, plus back to my regular day job on Monday morning.

I had blood in my urine. Never before (and never since) had I had a UTI not worsen -- and worsen rapidly -- when it got to the "peeing blood" point. Sitting on a toilet for the next 60 hours straight wasn't an option, and I think it's pretty silly for anyone to think that it should have been the proper course of action.

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Specializes in Telemetry.

Not an ED nurse, but I will say that there are plenty of threads here on AN that list many, many very obviously ridiculous CCs ED patients have come in with - often by ambulance.

While I haven't suffered from a UTI in the past, I have trouble putting it on the same list that has CCs like "I sat by a guy on the bus and he sneezed on me - I think I have Ebola!"..."I need a pregnancy test"..."I have a hang nail! " etc.

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Not an ED nurse, but I will say that there are plenty of threads here on AN that list many, many very obviously ridiculous CCs ED patients have come in with - often by ambulance.

While I haven't suffered from a UTI in the past, I have trouble putting it on the same list that has CCs like "I sat by a guy on the bus and he sneezed on me - I think I have Ebola!"..."I need a pregnancy test"..."I have a hang nail! " etc.

Thanks.... that's my viewpoint as well.

Something that calls for abx or other treatment is a valid reason to seek medical care, IMO.

A case of the sniffles or some normal nausea/vomiting/diarrhea -- those are things that will typically self-resolve and can be handled at home, unless we're talking about someone with a compromised immune system or a newborn infant, etc.

But broken bones, raging infections, etc., are not the kinds of things that should be put off for a couple days because they won't kill you immediately -- delaying treatment has an adverse effect.

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Well of course we would place you somewhere if you came in the ER. We are not allowed to send you away. Duh!! We are forced to see tons of patients that shouldn't be there or use the ER as their PCP, OB, dentist office Ect. No, particular s/s do not "warrant" fast track, but, like I said the ER is "obligated" to see every individual that walks through the door, regardless of how eyerolling the "EMERGENT" s/s are. I find, as well as many nurses I work with, that true patients that need immediate attention are compassionate and understanding. But like I said if you would like to discuss sepsis and pylo we can. Maybe wait a day and see how your "standard or normal" s/s feel. You were able to finish out work correct?

If you are eye rolling at patients for coming to an emergency room maybe you should consider a different career choice

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Well this thread is called what happened to emergency in emergency room? Allowing us to vent. So I'm thinking you should take your comment to another thread. :).

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Just my opinion have a nice day

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N/V/D is one of the top reasons people come into the ER!

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Specializes in Med Surg, PCU, Travel.
N/V/D is one of the top reasons people come into the ER!

All treatable at home so stock up on pepto and some immodium, gripe water and gatorade. Unless of course you got the occasional innocent "virgin" teen(sometimes adult) female who comes in with no idea she's just pregnant and no idea how it happened- you had unprotected sex! Thats how it happened...duh.

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All treatable at home so stock up on pepto and some immodium, gripe water and gatorade. Unless of course you got the occasional innocent "virgin" teen(sometimes adult) female who comes in with no idea she's just pregnant and no idea how it happened- you had unprotected sex! Thats how it happened...duh.

Unless of course its a baby under six months old and they have vomited more than 4 times

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